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DENT 322 - Image Interpretation > Benign Tumors > Flashcards

Benign Tumors Flashcards

1
Q

Definition of benign tumors of the jaw (3)

A
  • Slowly growing
  • Spread by direct extension and not by metastases
  • Tend to resemble the tissue of origin
    • Example: Ameloblastoma is composed of cells that resemble ameloblasts
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2
Q

8 clinical features of benign tumors of the jaw

A
  • Slowly growing
  • Painless
  • Sewlling (may present as bone expansion)
  • Do not metastasize
  • Not life threatening
  • Detected by enlargement of the jaws
  • Found by chance during radiographic examination
  • Lack of tooth eruption
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3
Q

Location of odontogenic benign tumors

A

Alveolar process

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4
Q

Location of vascular and neural benign lesions

A

Originate inside the mandibular canal

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5
Q

Location of cartilaginous benign tumors

A

Where redisual cartilaginous cells lie (around the mandibular condyle)

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6
Q

Describe the periphery and shape of benign tumpors

A
  • Smooth appearance of the borders
  • Well defined, sometimes corticated (sclerotic)
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7
Q

Describe the internal structure of benign tumors (3)

A
  • Radiolucnet, radiopaque, mixture of radiolucent and radiopaque tissues
  • Bony septa (unilocular or multilocular)
  • Internal pattern is characteristic for specific types of tumors
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8
Q

Describe the effect on surrounding structures of a benign tumor (4)

A
  • Outer cortical plate expansion
  • Tooth displacement
  • Root resorption
  • Displacement of the mandibular canal
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9
Q

Percentage of oral tumors that odontogenic tumors comprise

A

1 - 15%

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10
Q

3 categories of odontogenic tumors

A
  • Epithelial tumors
  • Mixed tumors (odontogenic epithelium and odontogenic ectomesenchyme)
  • Mesenchymal tumors (odontogenic ectomesenchyme)
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11
Q

4 types of odontogenic epithelial tumors

A
  • Ameloblastoma
  • Calcifying epithelial odontogenic tumor
  • Adenomatoid odontogenic tumor
  • Keratocystic odontogenic tumor
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12
Q

2 types of ameloblastoma

A
  • Multicystic variant
  • Unicystic variant
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13
Q

Most frequent odontogenic tumor

A

Ameloblastoma

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14
Q

3 general characteristics of ameloblastoma

A
  • Neoplasm of odontogenic epithelium
  • Agressive but benign growth characteristics
  • Arises from rests of the dental lamina and dental organ
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15
Q

8 clinical features of ameloblastoma

A
  • 30 - 60 years w/ average age ~40
  • No sex predilection
  • Frequently discovered during a routine radiographic exam
  • Increasing facial asymmetry
  • Mucosa over the lesion is normal
  • Teeth in the involved resion may be displaced
  • Painless
  • Risk of local recurrence (requires aggressive surgical resection)
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16
Q

Describe the radiographic location of ameloblastoma

A
  • Most (85%) develop in the mandible
  • Molar-ramus region
  • Third molar area of the maxilla
  • Can originate in an occlusal position to a developing tooth
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17
Q

Describe the radiographic periphery and shape of ameloblastoma

A
  • Well-defined
  • Curved outline
  • Small lesions are indistinguishable from a cyst
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18
Q

Describe the radiographic internal structure of ameloblastoma

A
  • Radiolucent
  • Presence of curved bony septa (soap bubble pattern)
  • Numerous small loculations (honeycomb pattern)
  • Unilocular or multilocular aspect
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19
Q

4 effects on surrounding structures of ameloblastoma

A
  • Tooth displacement
  • Tooth resorption
  • Bone expansion
  • Displacement of the mandibular canal
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20
Q

Differentiate between odontogenic myxoma and ameloblastoma

A

Odontogenic myxoma is not as expansible as ameloblastoma

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21
Q

3 differential diagnoses for ameloblastoma

A
  • Odontogenic keratocyst
  • CGCG
  • Odontogenic myxoma
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22
Q

Differentiate between ameloblastoma and odontogenic keratocyst

A

Less marked expansion and usually in posterior aspect of bone in association with impacted teeth

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23
Q

Differentiate between CGCG and ameloblastoma

A

CGCG = younger age group, wispy ill-defined septa

Usually localized to area anterior to 1st molar on mandible

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24
Q

Differentiate between odontogenic myxoma and ameloblastoma

A

Odontogenic myxoma is not as expansible as ameloblastoma

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25
Q

Treatment for ameloblastoma

A

Surgical resection with margins and potentially bone transplant subsequently (esp. if extensive)

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26
Q

4 general clinical features of unicystic ameloblastoma

A
  • May develop as a single entity
  • May derived from the epithelial linign of a dentigerous cyst
  • Occur in younger age group (average age = 23 yr)
  • Most frequent location = posterior body of the mandible (3rd molar)
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27
Q

Describe the radiographic features of unicystic ameloblastoma (3)

A
  • Radiolucent lesion
  • Well-defined
  • Often associated with 3rd molar
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28
Q

Differential diagnosis for unicystic ameloblastoma

A

Dentigerous cyst

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29
Q

Differentiate between unicystic ameloblastoma and dentigerous cyst

A

Dentigerous cyst identified via attachment of cyst to the CEJ of 3rd molar (unlike UA)

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30
Q

Describe the general flow chart of differentiating between tumors and cysts

A
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31
Q

3 general characteristics of calcifying epithelial odontogenic tumor

A
  • Pindborg tumor
  • Rare (account for about 1% of odontogenic tumors)
  • Originate from stratum intermedium of the enamel organ
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32
Q

5 clinical features of calcifying epithelial odontogenic tumor

A
  • Average age 40 yr
  • No sex predilection
  • Inraosseous location
  • Asymptomatic, jaw expansion (painless swellling)
  • Palpation reveals hard tumor
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33
Q

Describe the radiographic location of calcifying epithelial odontogenic tumor

A
  • Predilection for the mandible (2:1)
  • Premolar-molar area
  • Frequent association with an unerupted or impacted tooth (50%)
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34
Q

Describe the radiographic appearance of calcifying epithelial odontogenic tumor (4)

A
  • Well-defined lesion
  • Unilocular or multilocular with mixed radiolucent-radiopaque lesion
  • Appearance of radiopacities close to the crown of the impacted tooth
  • Tooth displacement, expansion of the jaw
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35
Q

4 differential diagnoses for Calcifying epithelial odontogenic tumor

A
  • Dentigerous cysts (if completely radiolucent interior)
  • Adenomatoid odontogenic tumor
  • Ameloblastic fibro-odontoma
  • Calcifying odontogenic cyst
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36
Q

3 general characteristics of adenomatoid odontogenic tumor

A
  • Account for 3 - 7 % of all oral tumors
  • Non-aggressive
  • Originates from enamel organ epithelium
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37
Q

5 clinical features of adenomatoid odontogenic tumor

A
  • 70% occur in the second decade
  • 90% appear before 30 years
  • Female predilection (2:1)
  • Slow growing tumor
  • Painless swelling
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38
Q

2 types of adenomatoid odontogenic tumors

A
  • Folicular type (associated with an embedded impacted tooth; in image)
  • Extrafollicular type (no embedded tooth)
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39
Q

Describe the radiographic location of adenomatoid odontogenic tumor

A
  • 75% occur in the maxilla
  • Incisor-canine-premolar region
  • Frequent association with an impacted tooth (i.e. canine)
40
Q

Describe the radiographic periphery of adenomatoid odontogenic tumor

A

Well-defined border

41
Q

Describe the radiographic internal structure of adenomatoid odontogenic tumors

A
  • Radiolucent, unilocular
  • Radiopacities in 2/3 of cases (snowflakes)
42
Q

Describe the MRI of adenomatoid odontogenic tumor

A
  • Homogenous hypersignal
  • Thick rim enhancement
43
Q

2 differential diagnoses for Adenomatoid odontogenic tumor

A

When tumor is completely radiolucent and is associated with an impacted tooth, difficult to differentiate with dentigerous cyst and odontogenic keratocyst

44
Q

2 ways to differentiate between Adenomatoid odontogenic tumor and dentigerous cyst

A
  • Calcifications may be present in Adenomatoid odontogenic tumor (snowflakes)
  • DC = attachment to the CEJ
45
Q

3 types of odontogenic mesenchymal tumors

A
  • Odontogenic myxoma
  • Cementoblastoma
  • Central odontogenic fibroma
46
Q

Define odontogenic myxoma

A

Benign, intraosseous, non-encapsulated neoplasm, that tend to infiltrate the surrounding cancellous bone

NOTE: Rare (3 - 6% of odontogenic tumors)

47
Q

Origin of odontogenic myxoma

A

Mesenchymal portion of the dental papilla

48
Q

5 clinical features of odontogenic myxoma

A
  • 25 - 30 years
  • No sex predilection
  • Slow growing
  • Painless swelling
  • Risk of local recurrence (20%)
49
Q

Radiographic location of odontogenic myxoma

A
  • Predilection for the mandible (3:1)
  • Premolar-molar area
50
Q

Describe the periphery and shape of odontogenic myxoma (radiograph)

A
  • Well-defined with corticated margin
  • Often poorly defined, especially in the maxilla (i.e. image)
51
Q

Describe the radiographic internal structure of odontogenic myxoma

A
  • Majority of lesions = mixed radiolucent-radiopaque internal pattern
  • Curved and coarse septa –> multilocular appearance
52
Q

3 effects of odontogenic myxoma on surrounding structures

A
  • Tooth displacement
  • Bone expansion
  • Expansion into sinus
53
Q

3 differential diagnoses for odontogenic myxoma

A
  • Ameloblastoma
  • CGCG
  • Osteosarcoma
54
Q

4 general characteristics of cementoblastoma

A
  • Slow growing mesenchymal neoplasm
  • Composed of cementum-like tissue and abnormal bone
  • Histologic characteristics are similar to those of osteoblastoma
  • Often develops with permanent teeth
55
Q

6 clinical features of cementoblastoma

A
  • Relatively young patients (less than 30 yrs)
  • No sex predilection
  • Solitary lesion
  • Slow growing
  • Involved tooth is vital and often painful
  • Relived by anti-inflammatory drugs
56
Q

2 effects of cementoblastoma on surrounding structures

A
  • Root resorption
  • Bone expansion
57
Q

Describe the periphery and shape of cementoblastoma

A
  • Well-defined radiopacity with corticated margin
  • Radiolucent band just inside the cortical border
58
Q

Location of cementoblastoma

A
  • More commonly in mandible
  • More commonly associated with a premolar or a first molar
59
Q

3 differential diagnoses for cementoblastoma

A
  • Focal periapical cemental dysplasia
  • Periapical sclerosing osteitis
  • Dense bone island
60
Q

Differentiate between focal periapical cemental dysplasia and cementoblastoma

A

More irregular outline with PCD + localized in anterior mandibular teeth

61
Q

How is cementoblastoma different from its differential diagnoses of periapical sclerosing osteitis and dense bone island

A

Both differentials lack soft tissue capsule

62
Q

3 general characteristics of central odontogenic fibroma

A
  • Rare odontogenic neoplasm
  • Contains mature fibrous tissue
  • May contain calcifications that resemble dysplastic dentin, cementum or osteoid tissue
63
Q

4 clinical features of central odontogenic fibroma

A
  • Average age = 4 yrs
  • Female preponderance
  • Asymptomatic
  • Painless swelling
64
Q

Location of central odontogenic fibroma

A
  • Occur more commonly in the mandible
  • Premolar-molar area
65
Q

Radiographic periphery and shape of central odontogenic fibroma

A

Well-defined

66
Q

Describe the radiographic internal structure of central odontogenic fibroma

A
  • Radiolucent
  • Fine internal septa
67
Q

2 effects of central odontogenic fibroma on surrounding structures

A
  • Tooth displacement and root resorption
  • Bone expansion
68
Q

2 differential diagnoses for central odontogenic fibroma

A
  • Odontogenic myxoma
  • CGCG
69
Q

3 types of mixed odontogenic tumors

A
  • Amelobastic fibroma
  • Ameloblastic fibro-odontoma
  • Odontoma
70
Q

4 general characteristics of ameloblastic fibroma

A
  • Benign mixed odontogenic tumor
    • Proliferation of epithelium resembling dental lamina
    • Proliferation of mesenchymal component resembling dental papilla
  • Enamel, dentin and cementum are not formed in this tumor
71
Q

5 clinical features of ameloblastic fibroma

A
  • Occur between 5 - 20 yrs
  • No sex predilection
  • Slow growing expansion
  • Painless swelling
  • Discovered on a routine dental RX
72
Q

Location of ameloblastic fibroma

A
  • Premolar-molar area of mandible
  • Often associated with an unreupted tooth (75%)
  • Located occlusal to the tooth
73
Q

Describe the radiographic periphery and shape of ameloblastic fibroma

A
  • Well-defined radiopacity with corticated margin (like a cyst)
  • Unilocular, radiolucent lesion
74
Q

3 effects on surrounding structures by ameloblastic fibroma

A
  • Associated unerupted tooth may be displaced in an apical direction
  • Root resorption
  • Bone expansion
75
Q

3 differential diagnoses of ameloblastic fibroma

A
  • Hyperplastic follicle
  • Dentigerous cyst
  • Ameloblastoma
76
Q

How to differentiate dentigerous cyst from ameloblastic fibroma

A

Attachment of DC at CEJ

77
Q

Define ameloblastic fibro-odontoma

A
  • Lesion very similar to ameloblastic fibroma
    • Ameloblastic fibroma with collections of enamel and dentin
  • Considered to be an early stage of a developing odontoma
78
Q

5 clinical features of ameloblastic fibro-odontoma

A
  • Commonly observed in young patients (<10 yrs)
  • No sex predilection
  • Slow growing
  • Painless swelling
  • Often associated with a missing tooth
79
Q

Effect of ameloblastic fibro-odontoma on surrounding structures

A

Apical tooth displacement

80
Q

Radiographic periphery and shape of ameloblastic fibro-odontoma

A

Well-defined sclerotic border

81
Q

Radiographic internal structure of ameloblastic fibro-odontoma

A
  • Mixed
  • Large lesion may present extensive calcifications
82
Q

Location of ameloblastic fibro-odontoma

A
  • More commonly located in posterior mandible
  • Center of lesion is occlusal to a developing tooth
83
Q

3 differential diagnoses of ameloblastic fibro-odontoma

A
  • Ameloblastic fibroma
  • Odontoma (complex odontoma)
  • CEOT
84
Q

Differentiate between ameloblastic fibro-odontoma and odontoma (complex odontoma)

A

AFOs have a greater soft tissue band (radiolucent)

85
Q

Differentiate between ameloblastic fibro-odontoma and CEOT

A

Calcifications are less dense in CEOT than those in ameloblastic fibro-odontoma

86
Q

Define odontoma

A
  • Characterized by the production of mature enamel, dentin, cementum, and pulp tissue
  • Considered to be a hamartoma and not a true tumor
    • Limited lesion
    • Well-differentiated tooth tissue
    • Slow-growing lesion
87
Q

2 types of odontoma

A
  • Complex odontoma (agglomerate of all dental tissues)
  • Compound odontoma (numerous tooth-like structures known as denticles)
88
Q

6 clinical features of odontoma

A
  • Often interfere with eruption of permanent teeth –> delayed eruption of adjacent teeth or retained primary teeth
  • Compound odontoma = twice as common as complex type
  • Most occur in the second decade
  • Commonly observed in young patients (<10 yrs)
  • No sex predilection
  • Discovered on routine dental RX
89
Q

Location of compound odontoma

A

Most occur in anterior maxilla (62%)

90
Q

Location of complex odontoma

A

Molar area of mandible mostly (70%)

91
Q

Radiographic appearance of odontoma

A

Well-defined sclerotic border

92
Q

Radiographic internal structure of odontoma (4)

A
  • Radiopaque
  • Compound type = number of toothlike structure of denticles
  • Complex = irregular mass of calcified tissue
  • Degree of opacity is equivalent to adjacent tooth structure
93
Q

3 effects of odontoma on surrounding structures

A
  • Interfere with normal eruption of teeth
  • Most associated with abnormalities such as impaction, malpositioning and diastema
  • Large complex odontoma may cause cortical expansion
94
Q

4 differential diagnoses for odontoma

A
  • Ameloblastic fibro-odontoma
  • Cemento-ossifying fibroma
  • Periapical cemental dysplasia
  • Dense bone islands
95
Q

Differentiate between odontoma and cemento-ossifying fibroma

A

Odontoma are often associated with unerupted teeth and are more radiopaque

96
Q

Differentiate between odontoma and periapical cemental dysplasia

A

Periapical cemental dysplasia features multiple lesions centered on the periapical regoin of teeth

97
Q

Differentiate between odontoma and dense bone islands

A

Dense bone islands do not present a soft capsule

DENT 322 - Image Interpretation (12 decks)

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